title: An assessment of the comprehension of the American Urological Association Symptom Index.
abstract: OBJECTIVE
  We determine the reading grade level of the American Urological Association (AUA) symptom index, and assessed patient ability to read and understand the index using a standardized reading and IQ test.
  
  
  METHODS
  The reading grade level required to read and understand the AUA symptom index was determined using the Spache and Dale-Chall readability formulas. A total of 202 men a mean of 66.1 years old completed the AUA symptom index, Wonderlic personnel test and scholastic level examination, and revised Ohio literacy test. Patients were instructed to report any difficulty in reading or understanding the AUA symptom score.
  
  
  RESULTS
  According to the Spache and Dale-Chall readability formulas, the AUA symptom index requires a grade 6 reading level. Of the 202 patients 30 (14.9%) did not complete the symptom index due to an inability to read it (28, 13.9%) and poor comprehension (2, 1%). Tested mean IQ and reading grade level was 91.7 and 11, respectively.
  
  
  CONCLUSIONS
  A grade 6 reading level is required to read and understand the AUA symptom index. A significant percentage of patients cannot read the index and require assistance from others for its completion. This assistance may introduce significant interviewer bias, potentially altering study outcome.
authors.affiliation: Department of Urology, University of Arkansas College of Medicine, Little Rock, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: MacDiarmid
authors.forename: T C
authors.initials: TC
authors.lastname: Goodson
authors.forename: T M
authors.initials: TM
authors.lastname: Holmes
authors.forename: P R
authors.initials: PR
authors.lastname: Martin
authors.forename: R B
authors.initials: RB
authors.lastname: Doyle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011470:Prostatic Hyperplasia / Q000175:diagnosis*; D011932:Reading; D011795:Surveys and Questionnaires